US9132011B2 - Femoral trial component - Google Patents

Femoral trial component Download PDF

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US9132011B2
US9132011B2 US13/731,575 US201213731575A US9132011B2 US 9132011 B2 US9132011 B2 US 9132011B2 US 201213731575 A US201213731575 A US 201213731575A US 9132011 B2 US9132011 B2 US 9132011B2
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medial
lateral
notch
femoral
fixation
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US20130116795A1 (en
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Thomas E. Wogoman
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DePuy Ireland ULC
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DePuy Ireland ULC
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Assigned to DEPUY (IRELAND) reassignment DEPUY (IRELAND) ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: DEPUY PRODUCTS, INC.
Assigned to DEPUY PRODUCTS, INC. reassignment DEPUY PRODUCTS, INC. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: WOGOMAN, THOMAS E.
Priority to US14/853,570 priority patent/US9402747B2/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4684Trial or dummy prostheses
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/28Bones
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/38Joints for elbows or knees
    • A61F2/3859Femoral components
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30767Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30841Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
    • A61F2002/30845Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes with cutting edges
    • A61F2002/30848

Definitions

  • the present disclosure relates generally to orthopaedic surgical instruments and, more particularly, to surgical instruments used on a patient's femur.
  • Joint arthroplasty is a well-known surgical procedure by which a diseased and/or damaged natural joint is replaced by a prosthetic joint.
  • a typical knee prosthesis includes a tibial tray, a femoral component, and a polymer insert or bearing positioned between the tibial tray and the femoral component.
  • Femoral components are designed to be attached to a surgically-prepared distal end of a patient's femur.
  • Tibial trays are designed to be attached to a surgically-prepared proximal end of a patient's tibia.
  • orthopaedic surgeons use a variety of orthopaedic surgical instruments such as, for example, prosthetic trial components, cutting blocks, drill guides, milling guides, and other surgical instruments.
  • Prosthetic trial components such as, for example, a femoral trial component and a tibial bearing trial component, are used to size and select the components of the knee prosthesis that will replace the patient's natural joint.
  • a procedure that utilizes the trial components to size and select the components of the knee prosthesis is often referred to as a trial reduction.
  • an orthopaedic surgical instrument includes a polymeric femoral trial component configured to be coupled to a surgically-prepared distal end of a patient's femur.
  • the femoral trial component includes an articular side having a posterior femoral condyle surface and a fixation side that is opposite the articular side.
  • the fixation side has a plurality of ribs that extend in a direction away from the articular side so as to define a plurality of pockets therebetween.
  • Each rib has an outer surface, and the outer surfaces of the ribs define a posterior fixation surface that extends generally in the superior/inferior direction and is configured to match the surgically-prepared distal end of the patient's femur.
  • the femoral trial component also includes a plurality of teeth extending from the posterior fixation surface in a direction away from the articular side.
  • Each tooth of the plurality of teeth has a pointed tip that defines a longitudinal axis of the tooth extending in the medial/lateral direction.
  • each tooth of the plurality of teeth may have a triangular cross-section. In some embodiments, the plurality of teeth may include at least four teeth.
  • the polymeric femoral trial component may be formed as a molded integral component.
  • the outer surfaces of a number of the plurality of ribs may further define a distal fixation surface extending generally in the anterior/posterior direction and a posterior-chamfer fixation surface extending superiorly and posteriorly from the distal fixation surface to the posterior fixation surface.
  • a second plurality of pockets may be defined in each of the distal fixation surface and the posterior-chamfer fixation surface between the plurality of ribs.
  • the femoral trial component may have an aperture defined in the distal fixation surface, and the aperture may extend from the fixation side to the articular side.
  • the femoral trial component may further include a lateral posterior condyle including the articular side and the fixation side that is opposite the articular side, and a medial posterior condyle.
  • the medial posterior condyle may include a second articular side including a second posterior femoral condyle surface and a second fixation side that is opposite the second articular side.
  • the second fixation side may have a second plurality of ribs that extend in a direction away from the second articular side so as to define a second plurality of pockets therebetween.
  • Each rib may have an outer surface and the outer surfaces of the ribs may define a second posterior fixation surface that extends generally in the superior/inferior direction and is configured to match the surgically-prepared distal end of the patient's femur.
  • the medial posterior condyle may also include a second plurality of teeth extending from the posterior fixation surface in a direction away from the second articular side.
  • the femoral trial component may further have a medial side and a lateral side.
  • the medial side may have at least one notch defined therein extending from the fixation side to the articular side
  • the lateral side may have at least one notch defined therein extending from the fixation side to the articular side.
  • the medial side may include two notches, and the lateral side may include two notches.
  • an orthopaedic surgical instrument includes a polymeric femoral trial component configured to be coupled to a surgically-prepared distal end of a patient's femur.
  • the femoral trial component includes an articular side having a posterior femoral condyle surface and a fixation side that is opposite the articular side.
  • the fixation side has a planar posterior fixation surface that extends generally in the superior/inferior direction and is configured to match the surgically-prepared distal end of the patient's femur.
  • a plurality of teeth extend from the planar posterior fixation surface in a direction away from the articular side. Each tooth has a pointed tip that defines a longitudinal axis of the tooth extending in the medial/lateral direction.
  • a plurality of pockets may be defined in the planar posterior fixation surface between the plurality of teeth.
  • an orthopaedic surgical instrument includes a polymeric femoral trial component configured to be coupled to a surgically-prepared distal end of a patient's femur.
  • the femoral trial component has a medial side, a lateral side, an articular side including a posterior femoral condyle surface, and a fixation side that is opposite the articular side.
  • the fixation side is configured to engage a posterior aspect of the surgically-prepared distal femur.
  • the polymeric femoral trial component also includes a first notch extending from the fixation side to the articular side that is defined in the medial side, and a second notch extending from the fixation side to the articular side that is defined in the lateral side.
  • the fixation side may include a plurality of ribs.
  • Each rib may have an outer surface and the outer surfaces may define a posterior fixation surface extending generally in the superior/inferior direction that is configured to match the surgically-prepared distal end of the patient's femur.
  • a plurality of teeth may extend from the posterior fixation surface in a direction away from the articular side. In some embodiments, the plurality of teeth may include at least four teeth.
  • each tooth of the plurality of teeth may have a pointed tip that defines a longitudinal axis of the tooth extending in the medial/lateral direction.
  • the femoral trial component may be formed as a molded integral component.
  • each tooth of the plurality of teeth may have a triangular cross-section.
  • FIG. 1 is a perspective view of an orthopaedic surgical instrument assembly
  • FIG. 2 is an exploded perspective view of the orthopaedic surgical instrument assembly of FIG. 1 ;
  • FIG. 3 is a perspective view of the femoral trial component of the orthopaedic surgical instrument assembly of FIG. 1 ;
  • FIG. 4 is a sagittal cross sectional view of the femoral trial component of FIGS. 1-3 ;
  • FIG. 5 is a bottom plan view of the femoral trial component of FIGS. 1-4 ;
  • FIG. 6 is a perspective view of the femoral trial component of FIGS. 1-5 positioned on a surgically-prepared distal end of a patient's femur;
  • FIG. 7 is a sagittal cross sectional view of the femoral trial component of FIGS. 1-6 on the surgically-prepared distal end of the patient's femur;
  • FIG. 8 is a perspective view of the orthopaedic surgical instrument assembly of FIG. 1 positioned on surgically-prepared ends of the patient's femur and tibia with the patient's knee in extension;
  • FIG. 9 is a perspective view of the orthopaedic surgical instrument assembly of FIG. 8 with the patient's knee in flexion.
  • anatomical references such as anterior, posterior, medial, lateral, superior, inferior, etcetera
  • terms representing anatomical references may be used throughout the specification in reference to the orthopaedic implants and surgical instruments described herein as well as in reference to the patient's natural anatomy.
  • Such terms have well-understood meanings in both the study of anatomy and the field of orthopaedics. Use of such anatomical reference terms in the written description and claims is intended to be consistent with their well-understood meanings unless noted otherwise.
  • the orthopaedic surgical instrument assembly 10 has a number of trial components 12 , including a femoral trial 14 , a tibial base trial 16 , and a tibial bearing trial 18 .
  • the femoral trial 14 is configured to be secured to a surgically-prepared end of a patient's distal femur 20 (see FIG. 6 )
  • the tibial base trial 16 is configured to be secured to a surgically-prepared end of a patient's proximal tibia 22 (see FIG. 8 ).
  • the tibial base trial 16 includes a plate 30 having an opening 32 defined therein sized to receive a base insert 34 .
  • the base insert 34 includes a body 36 having a number of fixation pins 38 extending away from a lower surface 40 of the body 36 .
  • the base insert 34 also includes a post 42 extending away from an upper surface 44 of the body 36 . It should be appreciated that in other embodiments the fixation pins 38 may be omitted from base insert 34 or additional fixation pins 38 may be added.
  • the tibial bearing trial 18 is configured to assist the surgeon in selecting a prosthetic tibial bearing component of a typical knee prosthesis.
  • the tibial bearing trial 18 is a multi-piece assembly that includes a bearing surface trial 46 and a shim 48 .
  • the post 42 of the base insert 34 is received in an opening 50 defined in the shim 48 and an opening (not shown) defined in the lower surface of the bearing surface trial 46 .
  • the bearing surface trial 46 includes a lateral articular surface 52 and a medial articular surface 54 positioned opposite the lower surface.
  • the bearing surface trial 46 is embodied as a fixed bearing trial and is fixed relative to the tibial base trial 16 (i.e., it is configured to not substantially rotate or move in the anterior/posterior direction or medial/lateral direction). In other embodiments, the bearing surface trial 46 may be a mobile bearing trial configured to rotate relative to the tibial base trial 16 . As shown in the illustrative embodiment, the tibial bearing trial 18 is a multi-piece assembly, but it should be appreciated that in other embodiments the tibial bearing trial 18 may be a single monolithic component.
  • One example of a tibial bearing trial 18 is shown and described in co-pending U.S. Patent Application Ser. No. 61/503,300, entitled “TRIALING SYSTEM FOR A KNEE PROSTHESIS AND METHOD OF USE” by Thomas E. Wogoman et al. which is incorporated herein by reference.
  • the femoral trial 14 of the orthopaedic surgical instrument assembly 10 is configured to assist the surgeon in selecting a femoral prosthetic component, which will emulate the configuration of the patient's natural femoral condyles.
  • the femoral trial 14 includes a lateral condyle surface 56 and a medial condyle surface 58 , which may be shaped (i.e., curved) in a manner that approximates the condyles of the natural femur.
  • the lateral condyle surface 56 and the medial condyle surface 58 are spaced apart from one another, thereby defining an intercondylar notch 60 therebetween.
  • the articular surfaces 52 , 54 of the tibial bearing trial 18 are configured to rotate with the lateral condyle surface 56 and the medial condyle surface 58 , respectively, of the femoral trial 14 .
  • the lateral condyle surface 56 and the medial condyle surface 58 are formed in an articular side 62 of the femoral trial 14 .
  • a fixation side 64 which is the side of the femoral trial 14 that contacts the surgically-prepared distal femur of the patient, is opposite the articular side 62 .
  • the fixation side 64 includes a plurality of ribs 66 that extend in a direction away from the articular side 62 .
  • Each of the ribs 66 includes an outer surface 68 , and the outer surfaces 68 of the ribs 66 cooperate to define multiple surfaces of the fixation side 64 .
  • Those surfaces, identified below as “fixation surfaces,” mate or match with planar surfaces surgically cut into the patient's femur, as discussed in greater detail below.
  • the femoral trial 14 is illustratively shown as a single integral or monolithic component, the trial 14 is characterized herein by a number of “regions” or “structures.”
  • the anterior structure of the femoral trial 14 is referred to herein as an anterior flange 70 .
  • the anterior flange 70 Moving along the femoral trial 14 from an anterior to posterior, the anterior flange 70 transitions to an anterior-chamfer region 72 , which transitions to a distal condylar region 74 .
  • the distal condylar region 74 transitions to a posterior-chamfer region 76 .
  • a pair of femoral condyles 78 forms the posterior structure of the femoral trial 14 .
  • One of the femoral condyles 78 is medially positioned and the other laterally positioned when the femoral trial 14 is attached to the distal end of the patient's resected femur 20 depending on which knee is being replaced.
  • each of the posterior femoral condyles 78 define a planar posterior fixation surface 82 on the fixation side 64 , with one of the posterior fixation surfaces 82 being the lateral fixation surface and the other medial fixation surface.
  • Each posterior fixation surface 82 is positioned opposite a posterior condyle surface 84 on the articulation side 60 . As shown in FIG. 4 , the posterior fixation surfaces 82 and the posterior condyle surfaces 84 extend generally in the superior/inferior direction.
  • the outer surfaces 68 of the ribs 66 of the distal condylar region 74 define a pair of planar distal fixation surfaces 86 (one being medially positioned, the other laterally positioned). Each of the distal fixation surfaces 86 is opposite a distal condyle surface 88 . As shown in FIG. 3 , the distal fixation surfaces 86 extend generally in the anterior/posterior direction.
  • the distal condylar region 74 also includes a pair of apertures or through-holes 90 , one of which is positioned laterally while the other is positioned medially.
  • Each through-hole 90 extends from an opening 92 defined in one of the distal fixation surfaces 86 to an opening 94 defined in the corresponding distal condyle surface 88 .
  • Each through-hole 90 is sized to receive a surgical drill, as described in greater detail below.
  • the posterior-chamfer region 76 of the femoral trial 14 includes a pair of planar posterior-chamfer fixation surfaces 96 defined by the outer surfaces 68 of the ribs 66 , with one being medially positioned and the other laterally positioned.
  • the lateral and medial posterior-chamfer fixation surfaces 96 extend superiorly and posteriorly from their respective lateral and medial distal fixation surfaces 86 to their respective posterior fixation surfaces 82 .
  • Each of the posterior-chamfer fixation surfaces 96 is positioned opposite a posterior-chamfer condyle surface 98 .
  • the anterior-chamfer region 72 includes a pair of planar anterior-chamfer fixation surfaces 100 .
  • Each anterior-chamfer fixation surface 100 is positioned opposite an anterior-chamfer condyle surface 102 .
  • the anterior-chamfer fixation surfaces 100 extend superiorly and anteriorly away from their respective lateral and medial distal fixation surfaces 86 to a planar anterior fixation surface 104 of the anterior flange 70 .
  • the anterior fixation surface 104 is opposite an anterior condyle surface 106 , and, like the posterior fixation surfaces 82 , the anterior fixation surface 104 extends generally in the superior/inferior direction.
  • the plurality of ribs 66 define a plurality of pockets 108 in each of the fixation surfaces 82 , 86 , 96 , 100 , and 104 .
  • the pockets 108 are separated such that none of the pockets are in fluid communication with each other. It should be appreciated that in other embodiments two or more pockets may be in communication with one another such that a single, continuous pocket is formed in the fixation side 72 of the femoral trial 14 . It will be appreciated that in other embodiments the pockets 108 may be omitted from one or more of the fixation surfaces.
  • the femoral trial 14 of the orthopaedic surgical instrument assembly 10 includes a plurality of teeth 110 that extend from each of the posterior fixation surfaces 82 in a direction away from the articular side 62 .
  • the teeth 110 are configured to engage or grip the surgically-prepared distal end of the patient's femur 20 when the femoral trial 14 is coupled thereto.
  • the illustrative teeth 110 extend parallel to each other in the medial/lateral direction. It should be appreciated that in other embodiments the teeth 110 may be angled relative to each other or arranged in various patterns on the posterior fixation surfaces 82 .
  • one or more of the teeth 110 may extend inferiorly/superiorly along the posterior fixation surface 82 in addition to, or instead of, extending medially/laterally as shown in FIGS. 3-4 . It should also be appreciated that in other embodiments one or more teeth may be formed on any of the other surfaces 82 , 86 , 96 , 100 , and 104 of the fixation side 64 of the femoral trial 14 .
  • each tooth 110 has a triangular cross section when viewed in the sagittal plane. It should be appreciated that in other embodiments the teeth 110 may have a square cross section, rectangular cross section, dome-shaped cross section, or any other cross section suitable to engage the surgically-prepared distal end of the patient's femur 20 . Additionally, while the teeth 110 have the same cross section in the illustrative embodiment, it should be appreciated that in other embodiments each tooth 110 may have a unique cross section.
  • Each tooth 110 has a body 112 including a base 114 fixed to the posterior fixation surface 82 between one or more of the pockets 108 .
  • the body 112 extends outwardly from the posterior fixation surface 82 to a tip 116 .
  • the tip 116 defines a longitudinal axis 122 of each tooth 110 extending in the medial/lateral direction.
  • the tip 116 of each body 112 is spaced apart from the posterior fixation surface 82 such that each tooth 110 has a height 120 .
  • the height 120 is approximately 0.38 millimeters. However, in other embodiments, the height 120 may be greater than that shown in the illustrative embodiment.
  • each tooth 110 has the same height 120 in the illustrative embodiment, it should be appreciated that in other embodiments the height 120 of each tooth 110 may vary.
  • the femoral trial 14 also includes a pair of sidewalls 124 , 126 that extend between the articular side 62 and the fixation side 64 , with one sidewall being medially positioned and the other laterally positioned depending on which knee is being replaced. As shown in FIG. 5 , each of the sidewalls 124 , 126 has a pair of notches 128 , 130 defined therein. The notch 128 extends between the articular side 62 and the fixation side 64 of the distal condylar region 74 and has a base surface 132 that connects the distal fixation surface 86 to the distal condyle surface 88 .
  • the notch 130 extends between the articular side 62 and the fixation side 64 of the distal condylar region 74 and the anterior-chamfer region 72 .
  • the notch 130 includes a base surface 134 that connects the distal fixation surface 86 to the distal condyle surface 88 , and a base surface 136 that connects the anterior-chamfer fixation surface 100 and the anterior-chamfer condyle surface 102 .
  • the notches 128 , 130 extend inwardly approximately 1.75 millimeters from the sidewalls 124 , 126 , respectively, to the base surfaces 132 , 134 , 136 .
  • the sidewalls 124 , 126 define an outer edge 138 of the femoral trial 14 corresponding to a standard femoral prosthetic component size.
  • the base surfaces 132 , 134 , 136 of the notches 128 , 130 define another edge 140 of the femoral trial 14 corresponding to a standard, but more narrow, femoral prosthetic component size.
  • a single femoral trial 14 may be used to size multiple femoral prosthetic component sizes.
  • one or more of the notches 128 , 130 may be omitted from the femoral trial 14 .
  • the position of the notches 128 , 130 along the sidewalls 124 , 126 may vary such that, for example, the notches 130 are formed entirely in the distal condylar region 74 .
  • the femoral trial 14 is constructed from a polymeric material.
  • the polymeric material is a fifty percent glass-reinforced nylon.
  • Another polymeric material that may be used is thirty percent glass-filled polyether ether ketone (PEEK) or polyethylene, such as ultrahigh molecular weight polyethylene (UHMWPE), although other biocompatible polymers may be used.
  • the tibial bearing trial 18 may be constructed from a material, such as, for example, any of the polymeric materials described above, which permits smooth articulation between the tibial bearing trial 18 and the femoral trial 14 .
  • the tibial base trial 16 and the base insert 34 may be constructed from a biocompatible metal, such as a cobalt chrome alloy; other materials, such as ceramics, may also be used.
  • a surgically-prepared distal end 200 of the patient's femur 20 includes a resected medial condyle 202 and a resected lateral condyle 204 .
  • the surgeon positions the femoral trial 14 over the distal end 200 of the patient's femur 20 .
  • An impactor assembly 206 may be used to impact the femoral trial 14 into the distal end 200 .
  • an engagement end 208 of the impactor assembly 206 is positioned in contact with the articular side 62 of the femoral trial 14 , and force is applied to the impactor assembly 206 until the fixation side 64 of the femoral trial 14 contacts the resected medial condyle 202 and the resected lateral condyle 204 .
  • the surgeon may remove the impactor assembly 206 . It should be appreciated that in other embodiments the surgeon may position the femoral trial 14 on the distal end 200 of the patient's femur 20 by hand without using the impactor assembly 206 .
  • the sidewalls 124 , 126 indicate where the outer edge of the standard femoral prosthetic component would be located on the resected medial condyle 202 and the resected lateral condyle 204 .
  • the base surfaces 132 , 134 , 136 of the notches 128 , 130 in the femoral trial 14 indicate where the outer edge of the narrow femoral prosthetic component would be located.
  • the surgeon may select the narrow femoral prosthetic component for implantation.
  • the resected medial condyle 202 and the resected lateral condyle 204 of the patient's femur 20 include a number of resected surfaces 210 . As shown in FIG. 7 , the resected surfaces 210 of each condyle 202 , 204 include a posterior planar surface 212 , a distal planar surface 214 , and an anterior planar surface 216 .
  • the resected surfaces 210 also include a posterior-chamfer planar surface 218 that extends superiorly and posteriorly from the distal planar surface 214 to the posterior planar surface 212 and an anterior-chamfer planar surface 220 that extends superiorly and anteriorly from the distal planar surface 214 to the anterior planar surface 216 .
  • the anterior fixation surface 104 of the femoral trial 14 contacts the anterior planar surfaces 216 of the patient's femur 20 and the distal fixation surfaces 86 of the femoral trial 14 contacts the distal planar surfaces 214 of the patient's femur 20 .
  • posterior-chamfer fixation surface 96 of the femoral trial 14 contacts the posterior-chamfer planar surface 218 of the patient's femur 20 .
  • the anterior-chamfer fixation surfaces 100 of the femoral trial 14 contacts the anterior-chamfer planar surfaces 220 of the patient's femur 20 .
  • the posterior fixation surfaces 82 of the femoral trial 14 grip the posterior planar surfaces 212 of the patient's femur 20 when the femoral trial 14 is positioned thereon.
  • one or more of the teeth 110 of the lateral posterior fixation surface 82 engages with, or grips, the posterior planar surface 212 of the resected lateral condyle 204 .
  • the engagement of the teeth 110 with the posterior planar surfaces 212 secures the femoral trial 14 to the distal end 200 of the patient's femur 20 .
  • the surgeon may also position the tibial base trial 16 on a surgically-prepared proximal end 230 of the patient's tibia 22 .
  • the tibial base trial 16 is secured to the surgically-prepared proximal end 230 of the patient's tibia 22 , as shown in FIG. 8 .
  • the tibial bearing trial 18 including the bearing surface trial 46 and the shim 48 , are positioned over the post 42 of the base insert 34 .
  • the lateral condyle surface 56 of the femoral trial 14 contacts the lateral articular surface 52 of the tibial bearing trial 18 , while the medial condyle surface 58 contacts the medial articular surface 54 .
  • the surgeon may then evaluate the range of motion and stability of the knee with the surgical instrument assembly 10 .
  • the load on the femoral trial 14 translates posteriorly as the knee is moved from extension (see FIG. 8 ) to flexion (see FIG. 9 ).
  • the force normal to the posterior condyle surfaces 84 of the femoral trial 14 increases, thereby causing the teeth 110 of the posterior fixation surfaces 82 of the femoral trial 14 to further engage, or grip, the posterior planar surfaces 212 of the surgically-prepared distal end 200 of the patient's femur 20 .
  • the engagement of one or more of the teeth 110 of the femoral trial 14 with the distal end 200 of the patient's femur 20 retains the femoral trial 14 on the patient's femur 20 .
  • screws or other fasteners may be inserted through the through-holes 90 into the femur 20 to provide additional fixation.

Abstract

An orthopaedic surgical instrument including a femoral trial component configured to be coupled to a surgically-prepared distal end of a patient's femur. The femoral trial component has a fixation side configured to engage a posterior aspect of the surgically-prepared distal femur.

Description

This application claims priority under 35 U.S.C. §120 to U.S. patent application Ser. No. 13/530,239, which was filed on Jun. 22, 2012 and which claimed priority under 35 U.S.C. §119 to U.S. Patent Application No. 61/503,237, which was filed on Jun. 30, 2011. Each of those application is incorporated herein by reference.
TECHNICAL FIELD
The present disclosure relates generally to orthopaedic surgical instruments and, more particularly, to surgical instruments used on a patient's femur.
BACKGROUND
Joint arthroplasty is a well-known surgical procedure by which a diseased and/or damaged natural joint is replaced by a prosthetic joint. A typical knee prosthesis includes a tibial tray, a femoral component, and a polymer insert or bearing positioned between the tibial tray and the femoral component. Femoral components are designed to be attached to a surgically-prepared distal end of a patient's femur. Tibial trays are designed to be attached to a surgically-prepared proximal end of a patient's tibia.
To facilitate the replacement of the natural joint with the knee prosthesis, orthopaedic surgeons use a variety of orthopaedic surgical instruments such as, for example, prosthetic trial components, cutting blocks, drill guides, milling guides, and other surgical instruments. Prosthetic trial components, such as, for example, a femoral trial component and a tibial bearing trial component, are used to size and select the components of the knee prosthesis that will replace the patient's natural joint. A procedure that utilizes the trial components to size and select the components of the knee prosthesis is often referred to as a trial reduction.
SUMMARY
According to one aspect of the disclosure, an orthopaedic surgical instrument includes a polymeric femoral trial component configured to be coupled to a surgically-prepared distal end of a patient's femur. The femoral trial component includes an articular side having a posterior femoral condyle surface and a fixation side that is opposite the articular side. The fixation side has a plurality of ribs that extend in a direction away from the articular side so as to define a plurality of pockets therebetween. Each rib has an outer surface, and the outer surfaces of the ribs define a posterior fixation surface that extends generally in the superior/inferior direction and is configured to match the surgically-prepared distal end of the patient's femur. The femoral trial component also includes a plurality of teeth extending from the posterior fixation surface in a direction away from the articular side. Each tooth of the plurality of teeth has a pointed tip that defines a longitudinal axis of the tooth extending in the medial/lateral direction.
In some embodiments, each tooth of the plurality of teeth may have a triangular cross-section. In some embodiments, the plurality of teeth may include at least four teeth.
Additionally, in some embodiments, the polymeric femoral trial component may be formed as a molded integral component. In some embodiments, the outer surfaces of a number of the plurality of ribs may further define a distal fixation surface extending generally in the anterior/posterior direction and a posterior-chamfer fixation surface extending superiorly and posteriorly from the distal fixation surface to the posterior fixation surface.
In some embodiments, a second plurality of pockets may be defined in each of the distal fixation surface and the posterior-chamfer fixation surface between the plurality of ribs. In some embodiments, the femoral trial component may have an aperture defined in the distal fixation surface, and the aperture may extend from the fixation side to the articular side.
Additionally, in some embodiments, the femoral trial component may further include a lateral posterior condyle including the articular side and the fixation side that is opposite the articular side, and a medial posterior condyle. The medial posterior condyle may include a second articular side including a second posterior femoral condyle surface and a second fixation side that is opposite the second articular side. The second fixation side may have a second plurality of ribs that extend in a direction away from the second articular side so as to define a second plurality of pockets therebetween. Each rib may have an outer surface and the outer surfaces of the ribs may define a second posterior fixation surface that extends generally in the superior/inferior direction and is configured to match the surgically-prepared distal end of the patient's femur. The medial posterior condyle may also include a second plurality of teeth extending from the posterior fixation surface in a direction away from the second articular side.
In some embodiments, the femoral trial component may further have a medial side and a lateral side. The medial side may have at least one notch defined therein extending from the fixation side to the articular side, and the lateral side may have at least one notch defined therein extending from the fixation side to the articular side.
In some embodiments, the medial side may include two notches, and the lateral side may include two notches.
According to another aspect, an orthopaedic surgical instrument includes a polymeric femoral trial component configured to be coupled to a surgically-prepared distal end of a patient's femur. The femoral trial component includes an articular side having a posterior femoral condyle surface and a fixation side that is opposite the articular side. The fixation side has a planar posterior fixation surface that extends generally in the superior/inferior direction and is configured to match the surgically-prepared distal end of the patient's femur. A plurality of teeth extend from the planar posterior fixation surface in a direction away from the articular side. Each tooth has a pointed tip that defines a longitudinal axis of the tooth extending in the medial/lateral direction.
In some embodiments, a plurality of pockets may be defined in the planar posterior fixation surface between the plurality of teeth.
According to another aspect, an orthopaedic surgical instrument includes a polymeric femoral trial component configured to be coupled to a surgically-prepared distal end of a patient's femur. The femoral trial component has a medial side, a lateral side, an articular side including a posterior femoral condyle surface, and a fixation side that is opposite the articular side. The fixation side is configured to engage a posterior aspect of the surgically-prepared distal femur. The polymeric femoral trial component also includes a first notch extending from the fixation side to the articular side that is defined in the medial side, and a second notch extending from the fixation side to the articular side that is defined in the lateral side.
In some embodiments, the fixation side may include a plurality of ribs. Each rib may have an outer surface and the outer surfaces may define a posterior fixation surface extending generally in the superior/inferior direction that is configured to match the surgically-prepared distal end of the patient's femur. A plurality of teeth may extend from the posterior fixation surface in a direction away from the articular side. In some embodiments, the plurality of teeth may include at least four teeth.
Additionally, in some embodiments, each tooth of the plurality of teeth may have a pointed tip that defines a longitudinal axis of the tooth extending in the medial/lateral direction. In some embodiments, the femoral trial component may be formed as a molded integral component. In some embodiments, each tooth of the plurality of teeth may have a triangular cross-section.
BRIEF DESCRIPTION OF THE DRAWINGS
The detailed description particularly refers to the following figures, in which:
FIG. 1 is a perspective view of an orthopaedic surgical instrument assembly;
FIG. 2 is an exploded perspective view of the orthopaedic surgical instrument assembly of FIG. 1;
FIG. 3 is a perspective view of the femoral trial component of the orthopaedic surgical instrument assembly of FIG. 1;
FIG. 4 is a sagittal cross sectional view of the femoral trial component of FIGS. 1-3;
FIG. 5 is a bottom plan view of the femoral trial component of FIGS. 1-4;
FIG. 6 is a perspective view of the femoral trial component of FIGS. 1-5 positioned on a surgically-prepared distal end of a patient's femur;
FIG. 7 is a sagittal cross sectional view of the femoral trial component of FIGS. 1-6 on the surgically-prepared distal end of the patient's femur;
FIG. 8 is a perspective view of the orthopaedic surgical instrument assembly of FIG. 1 positioned on surgically-prepared ends of the patient's femur and tibia with the patient's knee in extension; and
FIG. 9 is a perspective view of the orthopaedic surgical instrument assembly of FIG. 8 with the patient's knee in flexion.
DETAILED DESCRIPTION OF THE DRAWINGS
While the concepts of the present disclosure are susceptible to various modifications and alternative forms, specific exemplary embodiments thereof have been shown by way of example in the drawings and will herein be described in detail. It should be understood, however, that there is no intent to limit the concepts of the present disclosure to the particular forms disclosed, but on the contrary, the intention is to cover all modifications, equivalents, and alternatives falling within the spirit and scope of the invention as defined by the appended claims.
Terms representing anatomical references, such as anterior, posterior, medial, lateral, superior, inferior, etcetera, may be used throughout the specification in reference to the orthopaedic implants and surgical instruments described herein as well as in reference to the patient's natural anatomy. Such terms have well-understood meanings in both the study of anatomy and the field of orthopaedics. Use of such anatomical reference terms in the written description and claims is intended to be consistent with their well-understood meanings unless noted otherwise.
Referring to FIGS. 1-4, an orthopaedic surgical instrument assembly 10 is shown. The orthopaedic surgical instrument assembly 10 has a number of trial components 12, including a femoral trial 14, a tibial base trial 16, and a tibial bearing trial 18. The femoral trial 14 is configured to be secured to a surgically-prepared end of a patient's distal femur 20 (see FIG. 6), whereas the tibial base trial 16 is configured to be secured to a surgically-prepared end of a patient's proximal tibia 22 (see FIG. 8).
As shown in FIG. 2, the tibial base trial 16 includes a plate 30 having an opening 32 defined therein sized to receive a base insert 34. The base insert 34 includes a body 36 having a number of fixation pins 38 extending away from a lower surface 40 of the body 36. The base insert 34 also includes a post 42 extending away from an upper surface 44 of the body 36. It should be appreciated that in other embodiments the fixation pins 38 may be omitted from base insert 34 or additional fixation pins 38 may be added.
The tibial bearing trial 18 is configured to assist the surgeon in selecting a prosthetic tibial bearing component of a typical knee prosthesis. The tibial bearing trial 18 is a multi-piece assembly that includes a bearing surface trial 46 and a shim 48. The post 42 of the base insert 34 is received in an opening 50 defined in the shim 48 and an opening (not shown) defined in the lower surface of the bearing surface trial 46. The bearing surface trial 46 includes a lateral articular surface 52 and a medial articular surface 54 positioned opposite the lower surface. In the illustrative embodiment, the bearing surface trial 46 is embodied as a fixed bearing trial and is fixed relative to the tibial base trial 16 (i.e., it is configured to not substantially rotate or move in the anterior/posterior direction or medial/lateral direction). In other embodiments, the bearing surface trial 46 may be a mobile bearing trial configured to rotate relative to the tibial base trial 16. As shown in the illustrative embodiment, the tibial bearing trial 18 is a multi-piece assembly, but it should be appreciated that in other embodiments the tibial bearing trial 18 may be a single monolithic component. One example of a tibial bearing trial 18 is shown and described in co-pending U.S. Patent Application Ser. No. 61/503,300, entitled “TRIALING SYSTEM FOR A KNEE PROSTHESIS AND METHOD OF USE” by Thomas E. Wogoman et al. which is incorporated herein by reference.
The femoral trial 14 of the orthopaedic surgical instrument assembly 10 is configured to assist the surgeon in selecting a femoral prosthetic component, which will emulate the configuration of the patient's natural femoral condyles. As such, the femoral trial 14 includes a lateral condyle surface 56 and a medial condyle surface 58, which may be shaped (i.e., curved) in a manner that approximates the condyles of the natural femur. The lateral condyle surface 56 and the medial condyle surface 58 are spaced apart from one another, thereby defining an intercondylar notch 60 therebetween. The articular surfaces 52, 54 of the tibial bearing trial 18 are configured to rotate with the lateral condyle surface 56 and the medial condyle surface 58, respectively, of the femoral trial 14.
As shown in FIG. 3, the lateral condyle surface 56 and the medial condyle surface 58 are formed in an articular side 62 of the femoral trial 14. A fixation side 64, which is the side of the femoral trial 14 that contacts the surgically-prepared distal femur of the patient, is opposite the articular side 62. The fixation side 64 includes a plurality of ribs 66 that extend in a direction away from the articular side 62. Each of the ribs 66 includes an outer surface 68, and the outer surfaces 68 of the ribs 66 cooperate to define multiple surfaces of the fixation side 64. Those surfaces, identified below as “fixation surfaces,” mate or match with planar surfaces surgically cut into the patient's femur, as discussed in greater detail below.
Although the femoral trial 14 is illustratively shown as a single integral or monolithic component, the trial 14 is characterized herein by a number of “regions” or “structures.” For example, the anterior structure of the femoral trial 14 is referred to herein as an anterior flange 70. Moving along the femoral trial 14 from an anterior to posterior, the anterior flange 70 transitions to an anterior-chamfer region 72, which transitions to a distal condylar region 74. The distal condylar region 74 transitions to a posterior-chamfer region 76. A pair of femoral condyles 78 forms the posterior structure of the femoral trial 14. One of the femoral condyles 78 is medially positioned and the other laterally positioned when the femoral trial 14 is attached to the distal end of the patient's resected femur 20 depending on which knee is being replaced.
The outer surfaces 68 of the ribs 66 of each of the posterior femoral condyles 78 define a planar posterior fixation surface 82 on the fixation side 64, with one of the posterior fixation surfaces 82 being the lateral fixation surface and the other medial fixation surface. Each posterior fixation surface 82 is positioned opposite a posterior condyle surface 84 on the articulation side 60. As shown in FIG. 4, the posterior fixation surfaces 82 and the posterior condyle surfaces 84 extend generally in the superior/inferior direction.
The outer surfaces 68 of the ribs 66 of the distal condylar region 74 define a pair of planar distal fixation surfaces 86 (one being medially positioned, the other laterally positioned). Each of the distal fixation surfaces 86 is opposite a distal condyle surface 88. As shown in FIG. 3, the distal fixation surfaces 86 extend generally in the anterior/posterior direction.
The distal condylar region 74 also includes a pair of apertures or through-holes 90, one of which is positioned laterally while the other is positioned medially. Each through-hole 90 extends from an opening 92 defined in one of the distal fixation surfaces 86 to an opening 94 defined in the corresponding distal condyle surface 88. Each through-hole 90 is sized to receive a surgical drill, as described in greater detail below.
The posterior-chamfer region 76 of the femoral trial 14 includes a pair of planar posterior-chamfer fixation surfaces 96 defined by the outer surfaces 68 of the ribs 66, with one being medially positioned and the other laterally positioned. The lateral and medial posterior-chamfer fixation surfaces 96 extend superiorly and posteriorly from their respective lateral and medial distal fixation surfaces 86 to their respective posterior fixation surfaces 82. Each of the posterior-chamfer fixation surfaces 96 is positioned opposite a posterior-chamfer condyle surface 98.
Similarly, the anterior-chamfer region 72 includes a pair of planar anterior-chamfer fixation surfaces 100. Each anterior-chamfer fixation surface 100 is positioned opposite an anterior-chamfer condyle surface 102. The anterior-chamfer fixation surfaces 100 extend superiorly and anteriorly away from their respective lateral and medial distal fixation surfaces 86 to a planar anterior fixation surface 104 of the anterior flange 70. The anterior fixation surface 104 is opposite an anterior condyle surface 106, and, like the posterior fixation surfaces 82, the anterior fixation surface 104 extends generally in the superior/inferior direction.
The plurality of ribs 66 define a plurality of pockets 108 in each of the fixation surfaces 82, 86, 96, 100, and 104. In the illustrative embodiment, the pockets 108 are separated such that none of the pockets are in fluid communication with each other. It should be appreciated that in other embodiments two or more pockets may be in communication with one another such that a single, continuous pocket is formed in the fixation side 72 of the femoral trial 14. It will be appreciated that in other embodiments the pockets 108 may be omitted from one or more of the fixation surfaces.
The femoral trial 14 of the orthopaedic surgical instrument assembly 10 includes a plurality of teeth 110 that extend from each of the posterior fixation surfaces 82 in a direction away from the articular side 62. The teeth 110 are configured to engage or grip the surgically-prepared distal end of the patient's femur 20 when the femoral trial 14 is coupled thereto. The illustrative teeth 110 extend parallel to each other in the medial/lateral direction. It should be appreciated that in other embodiments the teeth 110 may be angled relative to each other or arranged in various patterns on the posterior fixation surfaces 82. Additionally, one or more of the teeth 110 may extend inferiorly/superiorly along the posterior fixation surface 82 in addition to, or instead of, extending medially/laterally as shown in FIGS. 3-4. It should also be appreciated that in other embodiments one or more teeth may be formed on any of the other surfaces 82, 86, 96, 100, and 104 of the fixation side 64 of the femoral trial 14.
As shown in FIG. 4, each tooth 110 has a triangular cross section when viewed in the sagittal plane. It should be appreciated that in other embodiments the teeth 110 may have a square cross section, rectangular cross section, dome-shaped cross section, or any other cross section suitable to engage the surgically-prepared distal end of the patient's femur 20. Additionally, while the teeth 110 have the same cross section in the illustrative embodiment, it should be appreciated that in other embodiments each tooth 110 may have a unique cross section.
Each tooth 110 has a body 112 including a base 114 fixed to the posterior fixation surface 82 between one or more of the pockets 108. The body 112 extends outwardly from the posterior fixation surface 82 to a tip 116. The tip 116 defines a longitudinal axis 122 of each tooth 110 extending in the medial/lateral direction. The tip 116 of each body 112 is spaced apart from the posterior fixation surface 82 such that each tooth 110 has a height 120. In the illustrative embodiment, the height 120 is approximately 0.38 millimeters. However, in other embodiments, the height 120 may be greater than that shown in the illustrative embodiment. Additionally, while each tooth 110 has the same height 120 in the illustrative embodiment, it should be appreciated that in other embodiments the height 120 of each tooth 110 may vary.
The femoral trial 14 also includes a pair of sidewalls 124, 126 that extend between the articular side 62 and the fixation side 64, with one sidewall being medially positioned and the other laterally positioned depending on which knee is being replaced. As shown in FIG. 5, each of the sidewalls 124, 126 has a pair of notches 128, 130 defined therein. The notch 128 extends between the articular side 62 and the fixation side 64 of the distal condylar region 74 and has a base surface 132 that connects the distal fixation surface 86 to the distal condyle surface 88. Similarly, the notch 130 extends between the articular side 62 and the fixation side 64 of the distal condylar region 74 and the anterior-chamfer region 72. The notch 130 includes a base surface 134 that connects the distal fixation surface 86 to the distal condyle surface 88, and a base surface 136 that connects the anterior-chamfer fixation surface 100 and the anterior-chamfer condyle surface 102. In the illustrative embodiment, the notches 128, 130 extend inwardly approximately 1.75 millimeters from the sidewalls 124, 126, respectively, to the base surfaces 132, 134, 136.
The sidewalls 124, 126 define an outer edge 138 of the femoral trial 14 corresponding to a standard femoral prosthetic component size. The base surfaces 132, 134, 136 of the notches 128, 130 define another edge 140 of the femoral trial 14 corresponding to a standard, but more narrow, femoral prosthetic component size. As such, a single femoral trial 14 may be used to size multiple femoral prosthetic component sizes. It should be appreciated that in other embodiments one or more of the notches 128, 130 may be omitted from the femoral trial 14. It should also be appreciated that in other embodiments the position of the notches 128, 130 along the sidewalls 124, 126 may vary such that, for example, the notches 130 are formed entirely in the distal condylar region 74.
The femoral trial 14 is constructed from a polymeric material. In the illustrative embodiment, the polymeric material is a fifty percent glass-reinforced nylon. Another polymeric material that may be used is thirty percent glass-filled polyether ether ketone (PEEK) or polyethylene, such as ultrahigh molecular weight polyethylene (UHMWPE), although other biocompatible polymers may be used. The tibial bearing trial 18 may be constructed from a material, such as, for example, any of the polymeric materials described above, which permits smooth articulation between the tibial bearing trial 18 and the femoral trial 14. The tibial base trial 16 and the base insert 34 may be constructed from a biocompatible metal, such as a cobalt chrome alloy; other materials, such as ceramics, may also be used.
Referring now to FIGS. 6-9, the orthopaedic surgical instrument assembly 10 is shown in use with the patient's bony anatomy. As shown in FIG. 6, a surgically-prepared distal end 200 of the patient's femur 20 includes a resected medial condyle 202 and a resected lateral condyle 204. In use, the surgeon positions the femoral trial 14 over the distal end 200 of the patient's femur 20. An impactor assembly 206 may be used to impact the femoral trial 14 into the distal end 200.
To do so, an engagement end 208 of the impactor assembly 206 is positioned in contact with the articular side 62 of the femoral trial 14, and force is applied to the impactor assembly 206 until the fixation side 64 of the femoral trial 14 contacts the resected medial condyle 202 and the resected lateral condyle 204. Once the femoral trial 14 is properly positioned on the distal end 200 of the patient's femur 20, the surgeon may remove the impactor assembly 206. It should be appreciated that in other embodiments the surgeon may position the femoral trial 14 on the distal end 200 of the patient's femur 20 by hand without using the impactor assembly 206.
When the femoral trial 14 is positioned on the distal end 200 of the patient's femur 20, the sidewalls 124, 126 indicate where the outer edge of the standard femoral prosthetic component would be located on the resected medial condyle 202 and the resected lateral condyle 204. Conversely, the base surfaces 132, 134, 136 of the notches 128, 130 in the femoral trial 14 indicate where the outer edge of the narrow femoral prosthetic component would be located. If the sidewalls 124, 126 extend beyond the resected medial condyle 202 and the resected lateral condyle 204 of the distal end 200 of the patient's femur 20, the surgeon may select the narrow femoral prosthetic component for implantation.
The resected medial condyle 202 and the resected lateral condyle 204 of the patient's femur 20 include a number of resected surfaces 210. As shown in FIG. 7, the resected surfaces 210 of each condyle 202, 204 include a posterior planar surface 212, a distal planar surface 214, and an anterior planar surface 216. The resected surfaces 210 also include a posterior-chamfer planar surface 218 that extends superiorly and posteriorly from the distal planar surface 214 to the posterior planar surface 212 and an anterior-chamfer planar surface 220 that extends superiorly and anteriorly from the distal planar surface 214 to the anterior planar surface 216.
When the femoral trial 14 is positioned on the distal end 200 of the patient's femur 20, the anterior fixation surface 104 of the femoral trial 14 contacts the anterior planar surfaces 216 of the patient's femur 20 and the distal fixation surfaces 86 of the femoral trial 14 contacts the distal planar surfaces 214 of the patient's femur 20. Similarly, posterior-chamfer fixation surface 96 of the femoral trial 14 contacts the posterior-chamfer planar surface 218 of the patient's femur 20. The anterior-chamfer fixation surfaces 100 of the femoral trial 14 contacts the anterior-chamfer planar surfaces 220 of the patient's femur 20.
Further, the posterior fixation surfaces 82 of the femoral trial 14 grip the posterior planar surfaces 212 of the patient's femur 20 when the femoral trial 14 is positioned thereon. As shown in FIG. 7, one or more of the teeth 110 of the lateral posterior fixation surface 82 engages with, or grips, the posterior planar surface 212 of the resected lateral condyle 204. The engagement of the teeth 110 with the posterior planar surfaces 212 secures the femoral trial 14 to the distal end 200 of the patient's femur 20.
In addition to positioning the femoral trial 14 on the distal end 200 of the patient's femur 20, the surgeon may also position the tibial base trial 16 on a surgically-prepared proximal end 230 of the patient's tibia 22. When the surgical instrument assembly 10 is fully installed, the tibial base trial 16 is secured to the surgically-prepared proximal end 230 of the patient's tibia 22, as shown in FIG. 8. The tibial bearing trial 18, including the bearing surface trial 46 and the shim 48, are positioned over the post 42 of the base insert 34. The lateral condyle surface 56 of the femoral trial 14 contacts the lateral articular surface 52 of the tibial bearing trial 18, while the medial condyle surface 58 contacts the medial articular surface 54. The surgeon may then evaluate the range of motion and stability of the knee with the surgical instrument assembly 10.
As the range of motion is evaluated, the load on the femoral trial 14 translates posteriorly as the knee is moved from extension (see FIG. 8) to flexion (see FIG. 9). As the load moves posteriorly, the force normal to the posterior condyle surfaces 84 of the femoral trial 14 increases, thereby causing the teeth 110 of the posterior fixation surfaces 82 of the femoral trial 14 to further engage, or grip, the posterior planar surfaces 212 of the surgically-prepared distal end 200 of the patient's femur 20. The engagement of one or more of the teeth 110 of the femoral trial 14 with the distal end 200 of the patient's femur 20 retains the femoral trial 14 on the patient's femur 20. It should be appreciated that in other embodiments screws or other fasteners may be inserted through the through-holes 90 into the femur 20 to provide additional fixation.
While the disclosure has been illustrated and described in detail in the drawings and foregoing description, such an illustration and description is to be considered as exemplary and not restrictive in character, it being understood that only illustrative embodiments have been shown and described and that all changes and modifications that come within the spirit of the disclosure are desired to be protected.
There are a plurality of advantages of the present disclosure arising from the various features of the method, apparatus, and system described herein. It will be noted that alternative embodiments of the method, apparatus, and system of the present disclosure may not include all of the features described yet still benefit from at least some of the advantages of such features. Those of ordinary skill in the art may readily devise their own implementations of the method, apparatus, and system that incorporate one or more of the features of the present invention and fall within the spirit and scope of the present disclosure as defined by the appended claims.

Claims (12)

The invention claimed is:
1. An orthopaedic surgical instrument for use prior to implantation of one of a plurality of sizes of femoral prosthetic components, the instrument comprising:
a first femoral prosthetic component having a first femoral prosthetic component size,
a second femoral prosthetic component having a second femoral prosthetic component size different from the first femoral prosthetic component,
a femoral trial component configured to be coupled to a surgically-prepared distal end of a patient's femur, the femoral trial component comprising:
an articular side comprising a femoral condyle surface having a curved contour corresponding with a curved contour of a femoral condyle surface of at least one of the femoral prosthetic components,
a fixation side that is opposite the articular side, the fixation side comprising a fixation surface configured to engage the surgically-prepared distal end of the patient's femur,
a medial side including a first medial surface and a second medial surface that extend between the femoral condyle surface and the fixation surface, and
a lateral side that is opposite the medial side, the lateral side including a first lateral surface and a second lateral surface that extend between the femoral condyle surface and the fixation surface,
wherein (i) the first medial surface and the first lateral surface define a first outer edge corresponding to the first femoral prosthetic component size, and (ii) the second medial surface and the second lateral surface define a second outer edge corresponding to the second femoral prosthetic component size.
2. The orthopaedic surgical instrument of claim 1, wherein:
a first medial-lateral dimension is defined between the first medial surface and the first lateral surface, the first medial-lateral dimension matching a medial-lateral dimension of the first femoral prosthetic component size, and
a second medial-lateral dimension is defined between the second medial surface and the second lateral surface, the second medial-lateral dimension matching a medial-lateral dimension of the second femoral prosthetic component size.
3. The orthopaedic surgical instrument of claim 1, wherein:
a first pair of spaced surfaces extend from the first medial surface, the second medial surface extends between and connects the first pair of spaced surfaces, the first pair of spaced surfaces and the second medial surface cooperate to define a medial notch,
a second pair of spaced surfaces extend from the first lateral surface, the second lateral surface extends between and connects the second pair of spaced surfaces, the second pair of spaced surfaces and the second lateral surface cooperate to define a lateral notch, and
the medial notch is substantially aligned with the lateral notch.
4. The orthopaedic surgical instrument of claim 3, wherein the first pair of spaced surfaces define a width of the medial notch and the second medial surface defines a length of the medial notch, the length of the medial notch being greater than the width of the medial notch.
5. The orthopaedic surgical instrument of claim 4, wherein:
the second pair of spaced surfaces define a width of the lateral notch and the second lateral surface defines a length of the lateral notch, the length of the lateral notch being greater than the width of the lateral notch, and
the length of the lateral notch is substantially equal to the length of the medial notch.
6. The orthopaedic surgical instrument of claim 5, wherein the width of the lateral notch and the width of the medial notch are each equal to approximately 1.75 millimeters.
7. The orthopaedic surgical instrument of claim 3, wherein:
the femoral trial component includes an anterior flange and a pair of posterior condyles, and
the medial notch and the lateral notch are positioned between the anterior flange and the pair of posterior condyles.
8. The orthopaedic surgical instrument of claim 7, wherein:
the medial notch is a first medial notch and the lateral notch is a first lateral notch,
the medial side includes a second medial notch positioned anterior to the first medial notch and partially defined by a third medial surface,
the lateral side includes a second lateral notch positioned anterior to the first lateral notch and partially defined by a third lateral surface, and
the second and third medial surfaces and the second and third lateral surfaces cooperate to define the second outer edge.
9. The orthopaedic surgical instrument of claim 8, wherein the second medial notch is substantially aligned with the second lateral notch.
10. The orthopaedic surgical instrument of claim 1, wherein:
the medial side includes a third medial surface extending between the femoral condyle surface and the fixation surface, the third medial surface being positioned anterior to the second medial surface,
the lateral side includes a third lateral surface extending between the femoral condyle surface and the fixation surface, the third lateral surface being positioned anterior to the second lateral surface, and
the second and third medial surfaces cooperate with the second and third lateral surfaces to define the second outer edge.
11. The orthopaedic surgical instrument of claim 10, wherein a first medial side surface extends from the second medial surface, a second medial side surface extends from the third medial surface, and the first medial surface connects the first medial side surface to the second medial side surface.
12. The orthopaedic surgical instrument of claim 11, wherein a first lateral side surface extends from the second lateral surface, a second lateral side surface extends from the third lateral surface, and the first lateral surface connects the first lateral side surface to the second lateral side surface.
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